1. Mental Health in Juvenile Justice 1 Cathy Craig-Myers Vicki Waytowich, Ed.D.

2. Mental Health in Juvenile Justice- what we want to learn Who are the kids coming into the system? What is the mental health data? What does it mean? Why is this so important? 2

3. Youth Arrests – Fl Juvenile Justice Population 3

4. 4 Source: Florida Department of Juvenile Justice Comprehensive Accountability Report. Figures for Diversion and Probation are preliminary. Youth Served in the Juvenile Justice System in Florida (FY 2013-14)

5. 5 DJJ Priority Funding Issues Current Year 2015-2016 Provide enhanced front end services i.e. SNAP, Respite, Prevention Security services at two Juvenile Assessment Centers Focus on Education/Career Education- Reentry and Transition Detention cost share between state and counties Funding to maintain safe and healthy facilities- FICO

6. 2008- Blueprint Commission Acknowledged youth with mental health issues often ended up in the juvenile justice system. 6 Mental Health in Juvenile Justice- Florida Guiding principles of DJJ include: Prevention and education are paramount Strengthen partnerships with judicial, legislative and community stakeholders Promote public safety through effective intervention Provide a safe and nurturing environment for our children Preserve and restore physical and mental health 2012 -DJJ Roadmap to System Excellence Change in philosophy DJJ responsible to screen and refer Emphasis on identification of trauma

7. Mental Health in Juvenile Justice- Georgetown Center for Juvenile Justice Reform 2/3 of the youth in the nation’s juvenile justice system have a diagnosable disorder. Georgetown JJ Reform Project 70% - diagnosable mental health disorder and 60% co-occurring disorder. Georgetown JJ Reform Project Community-based mental health services for youth suffering from mental health disorders has also been shown to lead to a significant reduction of youth placements in juvenile detention and other secure facilities.” Georgetown JJ Reform Project 7

8. National Center for Mental Health & Juvenile Justice Studies have consistently documented that: 65% to 70% of youth in contact with the juvenile justice system have a diagnosable mental health disorder; Over 60% of youth with a mental health disorder also have a substance use disorder; and Almost 30% of youth have disorders that are serious enough to require immediate and significant treatment. In addition, youth in the juvenile justice system have higher rates of exposure to traumatic experiences. Youth in the juvenile justice system experience mental health disorders at a rate that is more than three times higher than that of the general youth population. 8

9. Youth with serious mental illness make up 25% of the juvenile justice population, and their numbers are increasing. (National Federation of Families for Children’s Mental Health, 2008) Girls have more incidents of mental illness than boys, while boys have more externalizing disorders. (National Council on Crime and Delinquency, 2010) 70% of youth have one or more psychiatric disorders. ii NAMI -National Alliance of Mental Illness 20% of youth involved in the juvenile justice system have serious mental illnesses, including those that are suicidal, struggling with psychotic disorders and other serious illnesses. iii NAMI -National Alliance of Mental Illness 9 Mental Health in Juvenile Justice- National

10. 10 Mental Health in Juvenile Justice- Statewide State Methodology- gathering data JJIS Includes PACT and Pre-Pact Notice the stark difference in the numbers state profiles

11. Mental Health in Juvenile Justice Percentages of Florida Youth Reporting a History of Mental Health Problems, by Gender 11 PACT Profile FY2013-2014 Percentages of Youth Reporting A History of Mental Health Problems MalesFemalesAll Youth Intake19.121.619.8 Diversion15.016.015.4 Probation19.625.320.9 Commitments31.048.833.3. Source: 2014 PACT Profile. Available at: http://www.djj.state.fl.us/research/delinquency-data/pact-profile/pact-profile-fy2013-14

12. Mental Health in Juvenile Justice Percentages of Florida Youth Reporting a History of Mental Health Problems, by Race 12 Source: 2014 PACT Profile. Available at: http://www.djj.state.fl.us/research/delinquency-data/pact-profile/pact-profile-fy2013-14 PACT Profile Percentages of Youth Reporting a History of Mental Health Problems BlackWhiteHispanicOtherAll Youth Intake16.424.718.311.719.8 Diversion12.118.814.16.115.4 Probation16.828.617.111.520.9 Commitments28.544.728.716.733.3

13. Mental Health in Juvenile Justice Florida DJJ addresses youth’s mental health needs by: Screening and re-screening through PAT, CPACT, and RPACT Referring for assessment Referral for mental health treatment services Matching youth with appropriate service providers Case management and follow-up Service continuum mapping Annual trauma-informed care training 13

14. Local Methodology- At intake DJJ PACT pre screen is done Trauma Screen Suicide Screen CSEC Screening Community Providers Gain (1 st time offenders) SAMH-2-3 Comprehensive assessments 14 Mental Health in Juvenile Justice- Local

15. May June July Total Number of Youth Processed at the JAC 305 253 234 792 Number of Youth With a Hit on the Pre-PACT 197 216 180 593 (75%) Number of First Offenders Referred for Assessment 50 40 47 137 Number of First Time Offenders Assessed w/GAIN 33 27 31 91 (66%) Number of Youth with MH/SA issue31242883 (91%) Remaining Youth Referred for Assessment 147 176 133 456 Number of Youth Assessed by Gateway 42 56 48 146 (32%) Number of Youth with MH/SA issue *27 (64%) *42 (75%) *29 (60%)98 (67%) Total Number of Youth Screened/Assessed 197/75 (38%) 216/83 (38%) 180/79 (44%) 593/237 (40%) Total Number of Youth Assessed/Identified75/58 (77%)83/66 (80%)79/57 (72%) 237/181 (76%) 15 Mental Health in Juvenile Justice- Circuit 4

16. Florida DJJ defines Mental Health: An emotional or behavioral condition that interferes with daily activities and is diagnosed using well-recognized and standardized guidelines. Florida DJJ defines Trauma: Personal experience of violence and victimization including sexual abuse, physical abuse, severe neglect, loss, domestic violence, and/or the witnessing of violence, terrorism, or disasters. 16 Mental Health and Trauma Source: National Association of State Mental Health Program Directors (2006). DJJ Staff Development and Training.

17. Trauma-Informed Care Adverse Childhood Experiences (ACE)s may exert powerful influence over childhood brain development Youths with greater experiences of ACEs may become involved in the juvenile justice system earlier and comprise a greater proportion of those juveniles classified as Serious, Violent, and Chronic 17 Sources: Fox, B.H., Perez, N., Cass, E., Baglivio, M., Epps, N. (2015). Trauma changes everything: Examining the relationship between adverse childhood experiences and serious, violent and chronic juvenile offenders. Child Abuse & Neglect, 46: 163-173. Anda, R. F., Felitti, V. J., Bremner, J. D., Walker, J. D., Whitfield, C., Perry, B. D., Dube, S. R., & Giles, W. H. (2006). The enduring effects of abuse and related adverse experiences in childhood: A convergence of evidence from neurobiology and epidemiology. European Archives of Psychiatry and Clinical Neuroscience, 256: 174–186.

18. Trauma-Informed Care Trauma may create a roadblock for other meaningful delinquency intervention and/or mental health intervention to take place. 18

19. Trauma-Informed C are The prevalence of adverse childhood experiences (ACEs) among youth who received a full PACT screen (typically deeper-end youth ) 19 Source: Baglivio, M. T., Epps, N., Swartz, K., Sayedul Huq, M., Sheer, A., & Hardt, N. S. (2014). The Prevalence of Adverse Childhood Experiences (ACE) in the Lives of Juvenile Offenders. Journal of Juvenile Justice, 3: 1–23.

20. Accurately identify the need Develop a more coordinated approach to data collection Differentiate the data (trauma/MH/SA) DJJ should require their providers to report on the number of youth in their programs that receive mental health assessments and the resulting outcome. (state currently cannot query this information from JJIS) Modify/expand the capacity of JJIS to collect MH/SA information that can be aggregated 20 Potential Recommendations